Disabled patients could be put in cells

"This is an unacceptable situation for patients . . .'' CDHB chief of psychiatry Peri Renison

Intellectually disabled patients in Canterbury could be placed in prison if staff working in secure mental health units refuse to take the floor for safety reasons.

Canterbury District Health Board (CDHB) chief of psychiatry Peri Renison said management was ‘‘preparing to close other mental health inpatient services . . . should [Assessment, Treatment & Rehabilitation Unit] staff refuse to take the floor due to safety issues as [is] being advised by their unions’’.

‘‘Alternatively, all patients would need to be transferred to police or another facility.’’

Renison made the comments in a letter sent to the Ministry of Health in May, in which senior psychiatrists around the country raised concerns about patients and staff safety in secure units for intellectually disabled people who have committed crimes.

‘‘This is an unacceptable situation for patients, our staff and our community and it appears we are in the midst of a national system failure,’’ she wrote.

Anonymous sources said staff concerns had increased in recent months after assaults resulting in head injuries and, in some cases, minor brain damage.

Staff had been told by unions to stay in the nurses station if they were afraid for their safety. That happened 18 months ago when staff refused to take the floor for several hours until back up staff arrived.

CDHB mental health general manager Toni Gutschlag said the board had discussed challenges caused by staff vacancies with the Ministry of Health (MOH).

It was ‘‘not unusual’’ for management to anticipate a crisis and put a plan in place in case ‘‘things continue to deteriorate’’ and staff refused to take the floor.

Plans were under way to provide more space for patients.

Management had been in touch with police as they would need to take patients if the unit was not able to take them, but that had not happened yet, she said.

‘‘Police shouldn’t be a default health provider for people with disabilities.’’

Renison wrote in the letter to the ministry that one intellectually disabled man had his human rights breached by having to live in a forensic unit for well over 10 years ‘‘despite many discussions with MOH about the need for a suitable placement for him’’.

The ministry was responsible for the planning and funding of appropriate services for disabled people, ‘‘however we don’t see any movement in terms of expanding these services or any urgency with responding to the issues we are raising’’, she wrote.

The letter was backed by Chief Human Rights Commissioner David Rutherford and Children’s Commissioner Andrew Becroft.

They said under-funding and insufficient beds meant intellectually disabled patients were not getting the care they needed. They asked for a comprehensive independent review of the intellectual disability care sector.

Renison said last week the lack of a purpose-built facility for intellectually disabled patients charged with a criminal offence in Canterbury had resulted in repeated assaults on staff and patients, some witnessed by young people.

Canterbury had 10 beds available for such patients, requiring staff with a ‘‘very specific skills set’’, but the level of violence meant the unit was unable to take 10 people, she said.

‘‘Currently we have two people with intellectual disability in our forensic unit, which is really inappropriate for them. It also means that at times people cannot be admitted and have to remain in prison, either on remand or once they are sentenced.’’

Intellectually disabled people were a ‘‘vulnerable group who don’t have the ability to express what is happening for them or advocate for their own needs’’.

The Ministry of Health did not answer questions by deadline.